In the United States, chronic disease, like cardiovascular disease and diabetes, is the number one cause of death and disability. While chronic disease can take many forms, all share the common underlying cause: chronic, low-grade inflammation.
Inflammation isn’t always a bad thing, though. It's actually vital for survival. When you injure yourself or are trying to fight off a foreign invader (like a bacteria or virus), your immune system comes to the rescue with a variety of tools to clear the scene and ultimately restore homeostasis (balance). This type of acute inflammation allows you to survive and thrive despite the insult. However, when diet, lifestyle, and environmental factors trigger the inflammatory response unnecessarily, the resulting inflammatory cascade becomes chronic and, without intervention, can ultimately lead to the development of a disease.
In order to quiet the response and prevent the damage caused by chronic inflammation, you must pinpoint and then target what’s triggering the inflammatory response in the first place. In this article, we’ll discuss the specifics of inflammation, what causes it, and tests that can help you identify it. We’ll also dig into the anti-inflammatory diet and share the foods you’ll want to avoid and the foods you’ll want to bring in, as well as supplement options that help lower inflammation.
What is The Anti-Inflammatory Diet?
Food can affect the levels of inflammation in the body. Dietary patterns high in ultra-processed foods and low in nutrient-dense foods like fruits, vegetables, and whole grains tend to promote low-grade chronic inflammation that leads to disease development. On the other hand, an anti-inflammatory diet eliminates foods that can promote inflammation and instead focuses on foods that can prevent, reduce, or resolve it.
The Mediterranean diet is currently the most well-studied anti-inflammatory diet. It has been shown to reduce levels of inflammatory biomarkers like interleukin-6 (IL-6). While it’s not clear exactly why, the anti-inflammatory effect of this type of dietary pattern may be due to a variety of mechanisms like better blood sugar control, an improved gut microbiome profile, better immune system function, and lowered oxidative stress.
Anti-inflammatory diets aren't one-size-fits-all and should be tailored to individual patient’s needs. Essentially, any meal pattern that’s built around fruits, vegetables, unsaturated fats, whole grains, legumes, tea, coffee, herbs, spices, and oily fish would be considered anti-inflammatory. This type of diet also limits or completely excludes foods that can contribute to inflammation like high-fat red and processed meats, ultra-processed foods, refined grains, sugary foods and beverages, and excessive amounts of alcohol.
Food sensitivities are an additional consideration when planning an anti-inflammatory diet. Being sensitive to a certain food, whether it’s considered to be anti-inflammatory or not, can contribute to low-grade inflammation. So, the anti-inflammatory diet will ideally be tailored around any food sensitivities.
What Are Some Medical Conditions The Anti-Inflammatory Diet is Prescribed for?
Since an anti-inflammatory diet can help to prevent chronic inflammation, it’s a great idea for anyone to follow this way of eating. However, since chronic inflammation is a hallmark of most chronic diseases, people with conditions like obesity, metabolic syndrome, prediabetes and diabetes, autoimmune disease, cancer, arthritis, and cognitive decline are commonly prescribed an anti-inflammatory diet.
Context is key when it comes to inflammation. There are two kinds: acute inflammation and chronic inflammation. Acute inflammation is a survival mechanism that the body uses to repair damaged tissue and to fight off infections. In an acute state (like a cut or sprained ankle), the immune system sends inflammatory cells (leukocytes) to the affected area with resulting symptoms like reddened skin, pain, swelling, and heat. Once the job is completed (this could take hours or days), the body then down-regulates these inflammatory mediators to restore balance. But, if the body isn’t able to apply the brakes normally due to a continuous assault or a weakened immune system, these pro-inflammatory mediators continue to be released and can build up. This is where chronic inflammation comes into play and disease risk increases.
Symptoms of Inflammation
In chronic inflammation, some triggers, whether a microbe (like Helicobacter pylori), food, environment, or lifestyle, signals the immune system to send out pro-inflammatory mediators. This process can last much longer than the acute response, and over time, a buildup of reactive molecules can damage the tissues and organs of the body. People with chronic inflammation can experience symptoms that come and go like:
- Abdominal pain
- Chest pain
- Fatigue
- Fever
- Gastrointestinal distress
- Headaches
- Joint pain or stiffness
- Mouth sores
- Skin rash
- Weight gain
Functional Medicine Labs Commonly Used with The Anti-Inflammatory Diet
Testing for inflammation can be a challenge as common blood tests aren’t always diagnostic. Along with traditional blood tests, integrative providers can use many tests to look for the root causes of inflammation, like poor gut function, food sensitivities, bacterial overgrowth, and glucose dysregulation. Here are some functional medicine labs that may help identify and treat inflammation.
Comprehensive Stool Test
The GI-Map stool test by Doctor’s Data is a valuable test that analyzes stool samples for various markers of gastrointestinal health, including microbial imbalance, digestive enzyme levels, and inflammation. By identifying potential imbalances and digestive issues, this test can help to uncover the root causes of inflammation and guide targeted treatments to improve gut health and inflammation levels.
Food Sensitivity Testing
The Array-10 Multiple Food Immune Reactivity Screen by Cyrex Laboratories is a food sensitivity test that measures the body’s immune response to various foods. This test analyzes blood samples for IgG and IgA antibodies against common food proteins. Food sensitivities may be one driver of inflammation, so identifying them and personalizing an anti-inflammatory diet may be one way to target inflammation better.
SIBO Testing
The SIBO Breath Test by Genova Diagnostics is a non-invasive test that measures hydrogen and methane gases in the breath to assess the presence of small intestinal bacterial overgrowth (SIBO). SIBO can lead to increased intestinal permeability, which can be a root cause of chronic, low-grade inflammation. Targeting SIBO with antibiotics, probiotics, and dietary changes may help to restore gut balance and reduce inflammation.
Diabetes Testing
Since hyperglycemia is a root cause of inflammation, it’s essential to know if you have diabetes or prediabetes. Measuring biomarkers associated with the diagnosis of diabetes, like fasting insulin, fasting glucose, and hemoglobin A1c. With these tests, practitioners can make personalized nutrition and lifestyle recommendations to help patients normalize blood sugar and lower inflammation.
Additional Labs to Check
Traditional testing for inflammation can include four common blood tests.
Erythrocyte Sedimentation Rate (sed rate or ESR)
ESR measures how fast red blood cells settle. During inflammation, red blood cells fall faster. A typical normal value is less than 20mm/hr.
C-Reactive Protein (CRP)
CRP is made in the liver, this level tends to rise when inflammation is present. A typical normal value is less than 3mg/L.
Ferritin
Ferritin is a blood protein that reflects the iron stores in the body. When inflammation is present, ferritin levels rise. A typical normal value is 20 to 200mcg/L.
Fibrinogen
Fibrinogen is a protein that rises when inflammation is present. A typical normal value is 200 to 400 mg/dL.
* None of these are necessarily diagnostic on their own and no test for inflammation is perfect. Lab values and test results should only be one component of an overall, comprehensive evaluation.
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Foods to Eat on the Anti-Inflammatory Diet
Whole foods are the foundation of an anti-inflammatory diet. Let’s take a look at specific foods and why they’re included.
Fruits and Vegetables
Fruits and vegetables provide important phytonutrients, antioxidants, and fiber to help keep the gut microbiome balanced and reduce the inflammatory response. One study found close adherence to the Mediterranean diet improved the gut microbiome, which may explain some of its anti-inflammatory effects. In order to get the most nutrients, it’s best to consume a wide variety of both fruits and vegetables.
Whole Grains
Whole grains contain phytonutrients, vitamins, minerals, and fiber and have been found to positively impact the gut microbiome, possibly leading to an anti-inflammatory benefit. Whole grains include barley, brown rice, bulgur, farro, millet, quinoa, oatmeal, popcorn, and whole wheat flour.
Fish
Foods that contain long-chain omega-3 fatty acids are an excellent option for lowering inflammation. The omega-3 fats found in fatty fish include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Include two to three servings of fatty fish like salmon, mackerel, herring, trout, sardines, and tuna each week.
Healthy Fats
Healthy fats may help to lower inflammation in the body. For example, olive oil (a monounsaturated fat) contains antioxidants and polyphenols that are known to reduce proinflammatory mediators. Healthy fats to choose include olives and olive oil, avocados and avocado oil, nuts, and seeds.
Beans and Legumes
Beans and legumes contain a variety of polyphenols and fiber to help reduce inflammation. Include chickpeas, lentils, and a variety of beans into your diet to benefit from their heart-healthy properties.
Tea and Coffee
Green, white, black and oolong teas contain anti-inflammatory compounds like epigallocatechin gallate (EGCG), theasinensin A, and theaflavin, which have all been shown to reduce inflammatory mediators and inflammatory pathways in cancer patients.
Coffee contains a variety of bioactive compounds thought to provide anti-oxidant and anti-inflammatory benefits, which is protective against a number of chronic diseases.
Herbs and Spices
Various herbs and spices have been found to reduce pro-inflammatory mediators to provide an anti-inflammatory effect. Add garlic, ginger, turmeric, cinnamon, and cayenne to your favorite dishes next time you cook.
Foods to Avoid on The Anti-Inflammatory Diet
While consuming anti-inflammatory foods is key to lowering inflammation, those benefits will be negated if inflammatory foods are routinely consumed. Here are the foods to avoid and why they should be avoided on an anti-inflammatory diet.
Ultra-Processed Foods, Sweets, and Sugary Beverages
High intakes of ultra-processed foods are associated with low-grade inflammation. This could be because of a condition known as gut dysbiosis or disruption of the gut microbiome, which promotes increased intestinal permeability, immune system dysregulation, and inflammation.
Not only are ultra-processed foods high in calories, sodium, added sugars, potentially harmful additives, and potentially inflammatory fats, they’re also low in vitamins, minerals, phytonutrients, and fiber.
The most common ultra-processed foods include soft drinks and other sugar-sweetened beverages, processed bread, refined breakfast cereals, sugar-sweetened baked goods (cakes, pies, cookies, and brownies), pre-packaged sauces, frozen meals, and processed meats (hot dogs, salami, bacon, sausage, and pepperoni). Additional ultra-processed foods to avoid include processed foods made with high-fructose corn syrup or hydrogenated oils.
Inflammatory Fats
Trans fats, or partially hydrogenated oils, promote inflammation and occur naturally in small amounts in some foods like dairy and meat. Still, artificial trans fats (which have been banned in many countries) can be found in margarine, deep-fried foods, microwave popcorn, baked goods, pie crust, frozen pizza, cookies, and crackers.
High intakes of saturated fats from full-fat dairy products, partially hydrogenated oils, and fatty cuts of red meat and poultry may also contribute to low-grade, chronic inflammation.
Refined Grains
Foods high in refined carbohydrates, like white flour, white rice, and white bread, are quickly broken down into simple sugars, which are more rapidly absorbed. This process may lead to hyperglycemia (high blood sugar), which is known to increase inflammation.
Alcohol
Consuming alcohol, especially in excess, can drive gut-derived inflammation by increasing intestinal permeability, altering immune system function, and changing the composition of gut microbes.
Supplements and Herbs that Lower Inflammation
Food is powerful, but there are several supplements and spices that integrative providers can use in combination with the anti-inflammatory diet to prevent or lower inflammation.
Ginger
Ginger has multiple bioactive compounds, such as gingerols, shogaols, paradols, and zingerone, which are responsible for its medicinal and anti-inflammatory effects. Ginger can modulate the immune system response and limit inflammatory pathways and has been shown to have anti-inflammatory effects similar to non-steroidal anti-inflammatory drugs.
Turmeric
Curcumin, the active compond found in turmeric and has been shown to down-regulate many pro-inflammatory mediators and cytokines with resulting benefits for a variety of chronic inflammatory diseases. Bioavailability can be improved when curcumin is combined with piperine (black pepper).
Probiotics
Probiotics provide their anti-inflammatory benefits in a number of ways. They produce short-chain fatty acids, which among other benefits can reduce inflammation in the colon. Probiotics also upregulate polypeptides that lower inflammation, and play a role in tryptophan metabolism, which ultimately increases the production of anti-inflammatory cytokines.
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Summary
Acute inflammation is a protective mechanism that helps us recover from an injury or illness. However, we can develop chronic low-grade inflammation when the acute inflammatory response goes on longer than it should either from poor immune system function or a continuous trigger. This type of persistent inflammation is a root cause of many chronic diseases like diabetes, autoimmunity, cardiovascular disease, and cancer. If you already have, or are hoping to prevent a chronic disease, food is one powerful way to prevent, reduce, or resolve inflammation in the body.
An anti-inflammatory diet, like the Mediterranean diet, is built around a wide variety of fruits and vegetables, whole grains, fish, healthy fats, beans, legumes, herbs, spices, tea, and coffee. All of these contain various nutrients, phytonutrients, and fiber to help reverse the inflammatory process. The anti-inflammatory diet also strictly limits or even excludes inflammatory foods like ultra-processed foods, inflammatory fats, refined grains, and alcohol, and also takes food sensitivities into consideration.
In addition to using food as inflammation-fighting medicine, integrative providers may use targeted supplements like probiotics, ginger, and turmeric.
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